The Future of Healthcare and the Current Economic Crisis

We have a ‘sick care’, not a health care system. I am concerned that most of the proposals for fixing a national system (that most people will agree is broken) are not considering the role of alternative medicine and other forms of preventive wellness (such as nutrition or physical exercise) in reducing the incidence or severity of chronic illness and thereby the ultimate cost to society. If obesity contributes to diabetes and heart disease, then why are we so quick to pay for surgeries and drugs, and so very reluctant to help people with the cost of gym membership? Why do we ignore the benefits of acupuncture and massage therapy? Preventive wellness is better economics, and this perspective will be necessary if we are to have any hope of addressing the escalating costs.

Projected spending for 2009:
Total health spending is two and one-half trillion dollars
Health spending per person is over 8100 dollars
That amounts to about seventeen and one-half percent of our GDP

As a society, we made a choice early in the last century to choose technology over labor every time the choice came up. Human contact was discarded in favor of mechanization and pharmaceuticals. The current system of assembly-line depersonalized 15-minute contacts that characterizes orthodox health care is a direct result of this choice. Meanwhile, technology is responsible for almost two-thirds of cost growth. We can't afford the sick care system we currently have, a system that fails to provide any coverage at all to far too many of our fellow citizens. If we stay on this path, it will only get worse. We have the opportunity now to make a different choice.

The Commodification of Health Care By Bernard Lown, MD

"As medicine has conquered acute illness, it increasingly fails in coping with the growing toll of chronic disease - arthritis, cardiovascular ailments, cancer, diabetes, pulmonary impairments and neurological derangements. Lacking a cure, these illnesses require the art of healing for which the contemporary physician is poorly trained. And public, led to expect miracles which are not forthcoming, grows disillusioned and angry."

Report on The Healthcare Community Discussion. Sponsored by The Center for Mind-Body Medicine. December 30, 2008. James S. Gordon, M.D., Founder and Director Center for Mind Body Medicine.

"The current system, everyone agreed, often reimburses for expensive treatments of questionable value, instead of supporting preventive and self-care approaches. Small businesses, including doctors’ offices, we heard, cut services and raise fees to meet the escalating costs of their own employees’ healthcare—“It’s more than 15% a year,” a second family physician, who’d brought his budget with him, told us. Anxiety about health and coverage, our participants said again and again, contributes to the illnesses that demand coverage, and keep poorly covered people from seeking the help they need. The costs mount out of control while our national health grows worse—we spend far more money, our group members said with pain, incredulity, and outrage, live far less long and have far higher rates of infant mortality than just about any other industrial society."

"Whatever model of universal care is chosen, it must be grounded in a profoundly different point of view and practice from the current one, one in which prevention is as important as treatment and in which self-care and mutual help are understood as fundamental to both prevention and treatment."

"It can be grounded in an entire system which helps people who have felt discouraged and disrespected and alienated to become actively engaged in their own care."

The Role of Integrative Medicine in Healthcare Reform: Healthcare Reform Community Discussion
Report submitted to the Obama-Daschle healthcare transition team, based on Healthcare Community Discussions in Hawaii. Their focus was specifically on the role of integrative medicine in healthcare reform.

The group recommends that healthcare reform engage a major philosophical shift at the highest levels of public policy away from a primary emphasis on allopathic medicine to an integrative system of healthcare that treats the whole person, emphasizes the natural, least toxic and least intrusive approach to healthcare, educates the individual and engages him/her in making healthy lifestyle changes. Integrative healthcare combines the best of complementary and allopathic/conventional medicine to meet the needs of the individual.

A Team Approach to Health Care by Brandi Schlossberg

"It is important to our team to include integrated medicine because so much of a person's journey to find good health is a function of wanting to be in control of their health, and to do this using their own health-belief system," said Tindall. "People's personal health beliefs are not well understood, nor are they explored in the brief encounters that are the hallmark of a trip to a traditional clinician."
...
"This would help lower the cost of health care for everyone in the county," said McDonnell.

Study Finds Limited Risk From Making Massage a Covered Insurance Benefit

Our Health Care System Is Organized for the Wealthy -- We Can Change That

Hidden Hurt: Desperate for medical care, the uninsured flock by the hundreds to a remote corner of Virginia for the chance to see a doctor

Medicaid Integrative Therapies Pilot Project for Chronic Pain

"Summary: Medicaid costs are soaring. States are hurting. Strains from pain-related conditions factor in heavily. Meantime, surging prescriptions of pain medications create new sets of adverse consequences. Can an integrated care program featuring licensed acupuncturists, massage therapists and holistically-oriented nurse managers be part of the solution? Since 2002, via legislation and a Medicaid waiver, the state of Florida has engaged an "Integrative Therapies Pilot Project" to answer these questions. Chicago-based Alternative Medicine Integration Group (AMI) won the contract. This Integrator Special Report looks at AMI's clinical integration and payment model, patient and practitioner experience, and clinical and cost outcomes and controversies in the analysis of costs and cost-savings. Is this a model which Medicaid should widely promote?"

Adrian Langford, VP, AMI Florida, is blunt in his assessment of conventional management of chronic pain. The 20-year veteran of the managed care industry states: "Conventional primary care doctors don't know how to manage pain. They just throw drugs at them. Chronic pain is best managed through teaching people how to help manage their own pain."

Entitlement Reform Means Fixing the Broader Health System: Medicare and Medicaid’s Budget Challenges

Thanks largely to the introduction of new technologies, health care costs have grown an average of 9.8 percent each year—2.5 percentage points faster than the economy as a whole. This cost growth is not only putting health care increasingly out of reach for many Americans; it is a threat to our long-term economic prosperity. The Congressional Budget Office has predicted that unless we take action, health care spending could consume 49 percent of our GDP by 2082, causing wages to stagnate and depressing non-health care sectors of our economy.

Market-Driven Surgery and Quality of Care

In the U.S., a December 2003 study by the Agency for Health Research and Quality found that Medicare in 2001 paid over $3.2 billion for joint replacements in nearly 200,000 seniors, two-thirds of whom were women and one-third of whom were obese. Despite these 200,000 operations every year, the AHRQ researchers could find virtually nothing in the medical literature that documented the results of these operations other than improved mobility for the group as a whole and greater benefits from those suffering from rheumatoid arthritis.
Did it improve outcomes for the obese? Did the severity of arthritis matter? How long did it take before another operation was required? “The current state of empirical work does not provide a strong basis for making clinical recommendations,” the report concluded.

Disease-Led Recovery Illness props up the economy. Every new job created since 2001 can be accounted for by the increase in the health care field.

Costs of Health Care Administration in the United States and Canada by Steffie Woolhandler, M.D., M.P.H., Terry Campbell, M.H.A., and David U. Himmelstein, M.D. N Engl J Med 2003;349:768-75.

Administrative Waste Consumes 31 Percent of Health Spending

HealthReform.gov - The official U.S. Government Web site managed by the U.S. Department of Health & Human Services.

Promises about Health on the Obameter (What promises from Obama's Presidential campaign has he kept / broken / begun working on?)

Wellness Initiative for the Nation (WIN)

Purpose: The purpose of the Wellness Initiative for the Nation (WIN) is to proactively prevent disease and illness, promote health and productivity, and create well-being and flourishing for the people of America. WIN can also prevent the looming fiscal disaster in our health care system. In fact, effectively addressing preventable chronic illness and creating a productive, self-care society is our only long-term hope for changing a system that costs too much and is delivering less health and little care to fewer people.

Alternative medicine to the rescue by Deepak Chopra

"The very thing that mainstream medicine is weak at — making sure that we stay well before we get sick — hasn't been ignored by a swelling movement among people who desire more than a 15-minute visit with a distracted physician who winds up prescribing whatever drug has been recommended by his local pharmaceutical rep."

The Health Care Delivery System: A Blueprint for Reform The Center for American Progress and the Institute on Medicine as a Profession partnered to develop this online book of policy recommendations.

Proposal of the Physicians' Working Group for Single-Payer National Health Insurance

Senate Recovery and Reinvestment Act Sells Health Care Short

Behind Closed Doors, Repeating Mistakes from the Past on Health Care Reform

President Obama released a budget proposal that includes $634 billion to fund health care reform, days before a White House summit on health care reform begins. Like the Kennedy meetings, this summit currently does not include advocates for single-payer but is well-represented by lobbyists for the insurance industry and other groups who oppose fundamental reform.

Single-Payer Advocates Win Seats at White House Health Summit

Letting Dr. Fein and Congressman Conyers into the forum at the last minute was a small gesture indeed, and no doubt the vision of a mob of white-coated health care givers outside the White House gates had something to do with the decision to allow token presence of single-payer advocates. But, it was an improvement over being ignored completely. (Source: comment by Svejk)